Prebiotics can help to develop the gut and immune systems of young children via modulation of the gut microbiota(1), reducing the risk of infection and disease in later life. Breastmilk contains unique prebiotics and is associated with lower rates of infection, allergy and gut colonization of pathogenic bacteria, but not all parents can breastfeed. This review aims to understand if formula containing specific prebiotics can help modulate gut and immune outcomes in children up to 3 years, compared to standard formula.
A systematic literature review of randomised controlled trials (RCTs) was conducted without date limits using six international databases. RCTs that reported on gut or immune outcomes and included an intervention where a prebiotic blend containing short-chain galactooligosaccharides (scGOS) and long-chain fructooligosaccharides (lcFOS) [(scGOS/lcFOS ratio 9:1)] in formula were included. Studies were assessed for methodological quality and consistency of results using the Cochrane Risk of Bias tool and Health Canada Consistency Rating tool, respectively.
Twenty-eight studies were included, of which 24 were high quality (low risk of bias). scGOS/lcFOS prebiotic blend reduced incidence of respiratory and gastrointestinal infections, supported by increases in secretory IgA (first line of defense against pathogens in the gut) and decreases in stool pH. Improved markers of intestinal microbiota, including highly consistent beneficial increases in bifidobacteria and lactobacillus (beneficial bacteria), and decreases in clostridia (detrimental bacteria), were also reported. No study reported any unfavourable effects.
Formula with scGOS/lcFOS prebiotic blend improves intestinal microbiota and reduces incidence of infection. When exclusive breastfeeding is not feasible, nurses can improve childrens gut-immunity outcomes by recommending formula with added scGOS/lcFOS prebiotic blend, instead of standard formula.
Funding: This research was funded by Danone Nutricia.